Pacific Foundation: Project Safety Visit

• Site conducted

  Select

• Project Safety Visit

• Project Number & Name

• Project Supervisor

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 Safety Audit

1.1 General

• 1.1.1 Competent Person present?

  Yes

  No

  N/A

1.2 Guardrails

• 1.2.1 Guardrail Type<br><br>

  Bale Feeders

  Temporary Casing

  Scaffold Rail

  Other

• 1.2.2 Guardrail(s) in safe condition and set up properly?<br><br>

  Yes

  No

  N/A

1.3 Personal Fall Arrest Systems (PFAS)

• 1.3.1 PFAS Storage

  Safe

  At Risk

  N/A

• 1.3.2 PFAS Condition

  Safe

  At Risk

  N/A

• 1.3.3 PFAS Use

  Safe

  At Risk

  N/A

• 1.3.4 Anchorage Point(s)

  Safe

  At Risk

  N/A

• 1.3.5Harness inspection complete?

  Yes

  No

  N/A

1.4 Hole Covers

• 1.4.1 Hole Cover Type

  Safe

  At Risk

  N/A

• 1.4.2 Hole Cover Size

  Safe

  At Risk

  N/A

• 1.4.3 Hole Cover Signs

  Safe

  At Risk

  N/A

• 1.4.4 Hole Cover Securement

  Safe

  At Risk

  N/A

2.0 Drill Rigs

• 2.1 Drill Rig Number(s) & Model(s) on project.

  Yes

  No

  N/A

• 2.2 Work Platform(s)/Project Access

  Safe

  At Risk

  N/A

• 2.3 Overhead Powerlines/Obstructions

  Safe

  At Risk

  N/A

• 2.4 Operator's Manual

  Yes

  No

  N/A

• 2.5 Swing Radius Protection

  Safe

  At Risk

  N/A

• 2.6 Daily Inspections Performed

  Safe

  At Risk

  N/A

• 2.7 Properly Maintained

  Safe

  At Risk

  N/A

• 2.8 Operator's Station

  Safe

  At Risk

  N/A

• 2.9 Service Line Condition

  Safe

  At Risk

  N/A

• 2.10 Operator & Ground Hand Communication

  Safe

  At Risk

  N/A

• 2.11 Operator(s) Trained

  Safe

  At Risk

  N/A

3.0 Cranes

• 3.1 Crane Number(s) & Model(s) on project.

  Yes

  No

  N/A

• 3.2 Work Platform(s)/Project Access

  Safe

  At Risk

  N/A

• 3.3 Overhead Powerlines/Obstructions

  Safe

  At Risk

  N/A

• 3.4 Operator's Manual & Load Charts

  Yes

  No

  N/A

• 3.5 Swing Radius Protection

  Safe

  At Risk

  N/A

• 3.6 Daily Inspections Performed

  Safe

  At Risk

  N/A

• 3.7 Properly Maintained

  Safe

  At Risk

  N/A

• 3.7 Operator's Station

  Safe

  At Risk

  N/A

• 3.9 Qualified Signal Person In Place

  Safe

  At Risk

  N/A

• 3.10 Communication between qualified signal person and operator?

  Safe

  At Risk

  N/A

• 3.11 List Attachments for Crane Being Used

  Yes

  No

  N/A

• 3.12 Condition of attachments being used.

  Safe

  At Risk

  N/A

• 3.13 Operator(s) Trained

  Safe

  At Risk

  N/A

• 3.14 Lift Plan for critical lifts completed? (Lifts that are 75% or more of the crane's capacity and/or lifts made by multiple cranes)

  Yes

  No

  N/A

4.0 Loaders, Aerial Lifts, Forklifts, Other Mechanized Equipment

• 4.1 Equipment Number(s) & Model(s) on project.

  Yes

  No

  N/A

• 4.2 Work Platform(s)/Project Access

  Safe

  At Risk

  N/A

• 4.3 Overhead Powerlines/Obstructions

  Safe

  At Risk

  N/A

• 4.4 Daily Inspections Performed

  Safe

  At Risk

  N/A

• 4.5 Operator's Manual & Load Charts

  Yes

  No

  N/A

• 4.6 Operator's Station

  Safe

  At Risk

  N/A

• 4.7 Properly Maintained

  Safe

  At Risk

  N/A

• 4.8 List Attachments for Equipment Being Used

  Yes

  No

  N/A

• 4.9 Condition of attachments being used.

  Safe

  At Risk

  N/A

• 4.10 Operator(s) Trained

  Safe

  At Risk

  N/A

• 4.11 Employees aware of equipment movement?

  Safe

  At Risk

  N/A

5.0 Rigging

• 5.1 Synthetic Slings

  Safe

  At Risk

  N/A

• 5.2 Wire Rope Slings

  Safe

  At Risk

  N/A

• 5.3 Chain Slings

  Safe

  At Risk

  N/A

• 5.4 Continuos Loop/Round Slings

  Safe

  At Risk

  N/A

• 5.5 Spreaders with Sorter Hooks

  Safe

  At Risk

  N/A

• 5.6 Shackles

  Safe

  At Risk

  N/A

• 5.7 Lifting Eyes

  Safe

  At Risk

  N/A

• 5.8 Spreader Bar(s)

  Safe

  At Risk

  N/A

• 5.9 Turnbuckles

  Yes

  No

  N/A

• 5.10 Other

  Yes

  No

  N/A

6.0 Personal Protective Equipment (PPE)

• 6.1 Safety Glasses

  Safe

  At Risk

  N/A

• 6.2 Hard Hats

  Safe

  At Risk

  N/A

• 6.3 Hand Protection (Gloves)

  Safe

  At Risk

  N/A

• 6.4 Hearing Protection

  Safe

  At Risk

  N/A

• 6.5 Work Boots

  Safe

  At Risk

  N/A

• 6.6 Reflective Vest/Shirt (ANSI Level 2)

  Safe

  At Risk

  N/A

• 6.7 Respirators

  Safe

  At Risk

  N/A

• 6.7.1 Employees using respirators have been trained?

  Yes

  No

  N/A

• 6.8 Faceshields

  Yes

  No

  N/A

• 6.8.1 Employees are using face shields with safety glasses when changing teeth, grinding, chipping, etc.?

  Yes

  No

  N/A

7.0 Ladders

• 7.1 Are ladders being used properly for ladder type?

  Yes

  No

  N/A

• 7.2 Are ladders in good condition?

  Yes

  No

  N/A

• 7.3 Used according to instructions?

  Yes

  No

  N/A

• 7.4 For extension ladders are ropes, pulleys and treads in a good state of repair?

  Yes

  No

  N/A

9.0 Housekeeping & Material Storage

• 9.2 Drilling Tool Storage

  Safe

  At Risk

  N/A

• 9.3 Rebar Cage Storage<br>

  Safe

  At Risk

  N/A

• 9.1 Casing Storage

  Safe

  At Risk

  N/A

• 9.4 Other Materials

  Safe

  At Risk

  N/A

• 9.5 Trash

  Safe

  At Risk

  N/A

• 9.6 General Site Conditions

  Safe

  At Risk

  N/A

10.0 Fire Protection

• 10.1 Are fire extinguishers provided on all equipment?

  Yes

  No

  N/A

• 10.2 Are fire extinguishers provided on equipment secured?

  Yes

  No

  N/A

• 10.3 Are fire extinguishers of 20lb. rating placed at a minimum of 25' from containers with over 100 gallons of combustible?

  Yes

  No

  N/A

• 10.4 Are fire extinguishers in proper working order?

  Yes

  No

  N/A

• 10.5 Do fire extinguishers have a current annual inspection?

  Yes

  No

  N/A

• 10.6 Have fire extinguishers been visually inspected in the last 30 days?

  Yes

  No

  N/A

• 10.7 Do all cranes have at least a 5BC rated fire extinguisher?

  Yes

  No

  N/A

• 10.8 Flammable Liquids Storage

  Safe

  At Risk

  N/A

11.0 Welding & Cutting

• 11.1 Are compressed cylinders stored properly?

  Safe

  At Risk

  N/A

• 11.2 Are hoses for compressed gas use in safe condition?

  Yes

  No

  N/A

• 11.3 Are hoses stored properly? (Protected from abrasion and in a ventilated container)

  Yes

  No

  N/A

• 11.4 Are torch head assemblies and tips in safe working condition?

  Yes

  No

  N/A

• 11.5 Are flashback arrestors in place and being used at hose to regulator connections and/or hose to torch head connections?

  Yes

  No

  N/A

• 11.6 Is an appropriate striker provided and being used?

  Yes

  No

  N/A

• 11.7 Are regulators in safe working condition/free of damage?

  Yes

  No

  N/A

• 11.8 Is a fire extinguisher being provided for fire protection?

  Yes

  No

  N/A

• 11.9 Is appropriate protective clothing and PPE provided and being used?

  Yes

  No

  N/A

• 11.10 Are welding machines in safe working condition?

  Yes

  No

  N/A

• 11.11 Are leads to welding machines in safe working condition?

  Yes

  No

  N/A

• 11.12 Is a welding hood compatible with a hard hat provided and used?

  Yes

  No

  N/A

• 11.13 Are appropriate protective measures being taken to protect others from flash hazards of welding activities such as portable curtains?

  Yes

  No

  N/A

• 11.14 Is area of hot work clear of combustibles or sources of ignition?

  Yes

  No

  N/A

• 11.15 Is hot work permit is required?

  Yes

  No

  N/A

• 11.16 If hot work permit is required has it been completed?

  Yes

  No

  N/A

12.0 Electrical

• 12.1 Extension Cords

  Safe

  At Risk

  N/A

• 12.2 Ground Fault Circuit Interrupter(s) (GFCI) in use?

  Yes

  No

  N/A

• 12.3 Generators

  Yes

  No

  N/A

12.4 Power Tools

• 12.4.1 Power cords in safe condition?

  Yes

  No

  N/A

• 12.4.2 Side Handles provided and utilized where designed?

  Yes

  No

  N/A

• 12.4.3 Guarding in place where designed?

  Yes

  No

  N/A

• 12.4.4 General power tool condition?

  Safe

  At Risk

  N/A

13.0 Hand Tools

• 13.1 Impact tools (hammers, tooth insertion/extraction tools, chisels, punches) is safe condition? Free of broken handles and mushrooming.

  Yes

  No

  N/A

• 13.2 Tooth Insertion & Extraction Tools available and in use?

  Yes

  No

  N/A

• 13.3 Other hand tools in safe condition?

  Yes

  No

  N/A

14.0 First Aid Kit/Station

• 14.1 Is a first aid kit/station available?

  Yes

  No

  N/A

• 14.2 Are contents adequate?

  Yes

  No

  N/A

• 14.3 No contents past their expiration date?

  Yes

  No

  N/A

• 14.4 First Aid Kits/Cabinets clearly labelled?

  Yes

  No

  N/A

• 14.5 Are first aid kits/cabinets easily accessible?

  Yes

  No

  N/A

• 14.6 Employees aware of location of first aid kits/cabinet?

  Yes

  No

  N/A

• 14.7 Eye wash available and within expiration date?

  Yes

  No

  N/A

15.0 Project Field File

• 15.1 Project Field File available?

  Yes

  No

  N/A

• 15.2 Project Site Specific Safety Assessment completed properly and reviewed?

  Yes

  No

  N/A

• 15.3 Emergency Action Plan completed properly and reviewed?

  Yes

  No

  N/A

• 15.4 Utility Locate Ticket current and available?

  Yes

  No

  N/A

• 15.4.1 Utility locate performed?

  Yes

  No

  N/A

• 15.5 Project JHAs completed properly and reviewed?

  Yes

  No

  N/A

16.0 Pneumatic Tools and Air Supply

• 16.1 Air Compressor(s) in safe condition?

  Yes

  No

  N/A

• 16.2 Operator manual for air compressor available?

  Yes

  No

  N/A

• 16.3 OSHA Check valve in place on air compressor(s)?

  Yes

  No

  N/A

• 16.4 Air reservoir tanks in safe condition?

  Yes

  No

  N/A

• 16.5 OSHA Check valves in place on each reservoir outlet 1/2" or greater?

  Yes

  No

  N/A

• 16.6 Air lines in safe condition?

  Yes

  No

  N/A

• 16.7 Air line connections between hoses and hose to tool secured with whip check, whip sock, cotter pin, and/or wire?

  Yes

  No

  N/A

• 16.8 Pneumatic tools (rock drills, jack hammers, etc.) in safe condition?

  Yes

  No

  N/A

• 16.9 Discharge hoses free of excessive leaks?

  Yes

  No

  N/A

17.0 Safety Practices and Behaviors

• 17.1 Daily Safety meetings being held?

  Yes

  No

  N/A

• 17.2 Stretch and Flex being performed?

  Yes

  No

  N/A

• 17.3 Other contractor's employees involved in Daily Safety meetings or briefed separately on our activities?

  Yes

  No

  N/A

• 17.4 General attitude of employees on project positive?

  Yes

  No

  N/A

18.0 Other

• 18.1 Sanitary facilities?

  Safe

  At Risk

  N/A

• 18.2 Safety supplies on hand?

  Yes

  No

  N/A

• 18.3 Safety Data Sheets available on site or does the Foreman know how to access the information?

  Yes

  No

  N/A

• Yes

  No

  N/A

Lagging operations

• Has the competent person verified the soil conditions?

  Yes

  No

  N/A

• Is the bay exposed more than 5 feet?

  Safe

  At Risk

  N/A

• Is the Saw man using Chaps, face shield, safety glasses, and ear plugs?

  Yes

  No

  N/A

19.0 MSHA Specific Items

• 19.1 Roadways: proper berms, traffic controls, conditions

  Safe

  At Risk

  N/A

• 19.2 Highwalls: sloughing, loose material, hazards at edge

  Safe

  At Risk

  N/A

• 19.3 Stockpiles

  Safe

  At Risk

  N/A

• 19.4 Misc. Hazards: Sumps, Ponds, Equip.

  Safe

  At Risk

  N/A

• 19.5 Required MSHA training records for all employees onsite available on site?

  Yes

  No

  N/A

20.0 Quality Control

• 20.1 Are the plans current?

  Yes

  No

  N/A

• 20.2 Are the cut sheets current?

  Yes

  No

  N/A

• 20.3 Have the materials been verified?

  Yes

  No

  N/A

• 20.4 Has the slurry been tested for viscosity? Is it between a Ph of 6-8?

  Yes

  No

  N/A

• 20.5 Has the beam or cage set location been verified?

  Yes

  No

  N/A

• 20.6 Lagging quality, strait, proper amount of board behind webs, is it tight vertically?

  Yes

  No

  N/A

• 20.7 Has shaft locations been verified?

  Yes

  No

  N/A

• 20.8 Has shaft depth been verified?

  Yes

  No

  N/A

• 20.9 Is concrete mix spot checked and verified to be correct? Photo required!

  Yes

  No

  N/A

• 20.9.1 Have Drill Logs been completed? Photo Required!

  Yes

  No

  N/A

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• On site representative

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• Auditor's signature

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